Employment Support for People with Mental Illness

1. Employment Support for People with Mental Illness Providing Support Through Job Restructuring and Accommodation Laurie Ford Center for Continuing Education in Rehabilitation

3. Schizophrenia Difficulty filtering, processing, and acting on information One out of every three hundred people Most common mental illness seen in supported employment programs.

4. Mood (Affective) Disorders Depression, bipolar or manic-depressive illness The effects of these illnesses are often cyclical, with periods of stability.

5. Anxiety Disorders PTSD, Obsessive-Compulsive disorder, excessive fears Often co-occur with depression

6. Causes Mood, thought, and anxiety disorders are probably caused by a combination of genetics and stress Most develop in the late teens or early adulthood Impact ranges from moderate to severe

7. Personality Disorders Long-term problems in adjustment Emotionally needy Seeking attention inappropriately Nonassertive Always getting in trouble Volatile, unstable

8. Impact of Mental Illness Poverty, stigma, and discrimination Unpredictable onset Cycle of illness and effects of symptoms Side effects of medication Possible need for hospitalization.

9. Impact of Unemployment Loss of time structure Loss of social participation and support Loss of identity and self esteem

10. Learning/Performance Issues Trouble Initiating Action � Cognitive Problems � Difficulty Concentrating, Distractibility � Impairment of Insight and Judgment � Difficulty in Organization and Planning

11. Interpersonal Issues Alienated from Feelings Social Isolation or Withdrawal � Peculiar or Bizarre Behaviors Dysfunctional Personality Traits Suspiciousness/Paranoia Decreased Concern for Hygiene

12. Physical Issues Physical restlessness Sleep disturbance Slowed gait or awkward movements

13. Relating to People with MI Ask about their experiences � Train yourself to be an expert observer � Employ active listening techniques � Don�t be afraid to ask questions.

14. Relating to People with MI Display your empathy � Help people name their feelings � Stay focused on here-and-now situations. � Build trust by going at the client's pace

15. A Study on Accommodations 194 employees in 26 SE programs in 3 states. 322 reasonable accommodations were provided by 209 employers.

16. Awareness Most workers were unaware of the ADA, their rights to accommodation, or the types of accommodation that might benefit them Employers were familiar with the ADA, but weren't aware that they had arranged accommodations

17. Common Accommodations Flexible scheduling Part time work or job sharing Frequent or flexible breaks Changes in start/finish times Time off for appointments Flexible policies for paid or unpaid leave

18. Common Accommodations Supervision and Job Structuring Extra supervision Providing written assignments or instructions Breaking down assignments into smaller tasks Use of checklists Job coaching Providing frequent feedback

19. Common Accommodations Modified work environment Allowing employees to eat or drink as needed Allowing phone calls at work for information or support Work at home to minimize stimuli Workspace with walls or sound barriers Opportunities for movement Give choices regarding work area

20. Common Accommodations Assistive Technology Typewriter or PC to compensate for tremors Magnifying devices, large print Earphones, radio, white noise Non-glare work or flooring surfaces Watch, computer, beeper with prompts Noise modulation Simple ergonomic modifications

21. Being Reasonable �It�s a very simple philosophy � empty what�s full; fill what�s empty; and scratch where it itches.� �Everyone uses some sort of reasonable accommodation to reduce barriers and inconveniences in their everyday lives. Turning on a desk lamp� is as much a �reasonable accommodation� as is a ramp for a person who uses a wheelchair.� Mary Lee Stocks, 1996

22. Helping with Symptom Management Symptoms which indicate a relapse Changes in behavior, feelings, thoughts Take them seriously, increase support, encourage person to get medical help

23. Helping with Symptom Management Symptoms which stand out, cause embarrassment, frighten others Bizarre, socially unusual behaviors � delusions, talking to self, loose associations Changing meds or dosage may help Direct feedback or skill training

24. Helping with Symptom Management Symptoms which increase isolation Apathy, social withdrawal, poverty of thought, blunting of emotions Have friends, activities, places to belong; educate others in the workplace

25. Helping with Symptom Management Symptoms of another disorder or illness Poor health care is common These may not be recognized or treated, but can complicate the employment situation

26. Helping with Symptom Management Medication Side Effects Blurred vision, drowsiness, slowed movement, stiffness, restlessness, mental fogginess Might be improved through changes in meds, dosages, schedule

27. The final word on support� � Use careful job matching Know the warning signs and patterns; AND the things that help improve the worker�s outlook and performance.

28. final word, continued�. � Be skilled in job analysis, systematic instruction, adult learning principles, learning styles, and accommodation strategies Use a �village� approach � everyone needs a variety of supports